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Biomarkers for Risk Prediction in Acute Decompensated Heart Failure

  • Decompensated Heart Failure (JE Ho, Section Editor)
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Abstract

Risk prediction in patients admitted with acute decompensated heart failure (ADHF) remains a challenge. Biomarkers may improve risk prediction, which in turn may help to better inform patients regarding short-term and long-term prognosis, therapy and care. Most data on biomarkers have been derived from patient cohorts with chronic heart failure. In ADHF, currently, risk tools largely rely on common clinical and biochemical parameters. However, ADHF is not a single disease. It presents in various manners and different etiologies may underlie ADHF, which are reflected by different biomarkers. In the last decade, many studies have reported the prognostic value of these biomarkers. These studies have attempted to describe a value for statistical modeling, e.g., reclassification indices, in an effort to report incremental value over a clinical model or the “gold standard”. However, the overall incremental predictive value of biomarkers has been modest compared to already existing clinical models. Natriuretic peptides, e.g., (NTpro-)BNP, are the benchmark, but head-to-head comparisons show that there are novel biomarkers with comparable prognostic value. Multimarker strategies may provide superior risk stratification. Future studies should elucidate cost-effectiveness of single or combined biomarker testing. The purpose of this review was to provide an update on current biomarkers and to identify new promising biomarkers than can be used in prognostication of acute heart failure.

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Conflict of Interest

A. Rogier van der Velde declares that he has no conflict of interest.

Wouter C. Meijers declares that he has no conflict of interest. The University Medical Center Groningen, where the authors are employed, has received research grants from BG Medicine.

Rudolf A. de Boer has received research grants from Abbott and Netherlands Organisation for Scientific Research, NWO VIDI grant (No. 917.13.350), consultancy and/or speaker fees from Abbott, AstraZeneca, Biomérieux, BG Medicine, Pfizer, Baxter, and Novartis, and has ownership interest in Pectacea.

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  1. Department of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands

    A. Rogier van der Velde, Wouter C. Meijers & Rudolf A. de Boer

  2. Department of Cardiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands

    Rudolf A. de Boer

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  1. A. Rogier van der Velde
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van der Velde, A.R., Meijers, W.C. & de Boer, R.A. Biomarkers for Risk Prediction in Acute Decompensated Heart Failure. Curr Heart Fail Rep 11, 246–259 (2014). https://doi.org/10.1007/s11897-014-0207-7

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